Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

I am a lamaze childbirth educator in Southern
CA. Here is my question. I discuss that the number of
vaginal exams preformed during a labor and delivery experience is
limited (or should be!) because the act of doing the exam, although
sterile, displaces the normal bacteria from its normal positioning,
thereby increasing the chance for infection to develop. Perhaps I
need to change that explanation to state that this is true only
after the water has broken, but I thought I understood the chance
of increased infection was true in either case, only more so after
water has broken.

I was asked why infection wouldn’t happen as a result of
penis insertion during sexual intercourse and I answered that in a
low risk no
problem pregnancy there are not sexual restrictions but agreed that
I needed to do further research as to why those two scenarios are
different. If you can provide me a resource or additional info I
would appreciate the learning opportunity.

It is my understanding that there is no increased risk of
infection with vaginal exams if membranes are intact. As for
why vaginal intercourse differs from a digital cervical exam, as
you can see in this
drawing, the cervix isn't in line with the end of the
vagina. During intercourse, the penis slides by it into the
closed pouch at the top of the vagina. Furthermore, pregnant
women produce more abundant mucous, which I would think would
serve to wash bacteria back down and out. By contrast, with a
cervical exam, the examiners fingers push into the cervical
opening, depositing there any bacteria swept up onto the examiners
gloved fingers as they were inserted.

It is my understanding that there is no increased risk of infection
with
vaginal exams if membranes are intact. As for why vaginal
intercourse
differs from a digital cervical exam, as you can see in this
drawing
<http://www.motherrisingbirth.com/wp-content/uploads/2012/10/pregnancy.gif>
, the cervix isn't in line with the end of the vagina. During
intercourse,
the penis slides by it into the closed pouch at the top of the
vagina.
Furthermore, pregnant women produce more abundant mucous, which I
would
think would serve to wash bacteria back down and out. By contrast,
with a
cervical exam, the examiners fingers push into the cervical
opening,
depositing there any bacteria swept up onto the examiners gloved
fingers as
they were inserted.